A removable partial denture enables the restoration or improvement of 4 oral functions: aesthetics, mandibular stability, mastication, and speech. However, wearing a removable partial denture should not cause oral comfort to deteriorate. There are 3 types of removable partial dentures: acrylic tissuesupported dentures, dentures with cast metal frameworks en dentures with cast metal frameworks and (semi)precision attachments. Interrupted tooth arches, free-ending tooth arches, and a combination of interrupted as well as free-ending tooth arches can be restored using these dentures. Well-known disadvantages of removable partial dentures are problematic oral hygiene, negative influence on the remaining dentition and limited oral comfort. Due to the advanced possibilities of fixed tooth- or implant-supported partial dentures, whether or not free-ending, or tooth- as well as implant-supported partial dentures, the indication of removable partial dentures is restricted. Nevertheless, for the time being the demand for removable partial dentures is expected to continue.

Since there are many ways of preserving a natural dentition, if necessary with support of solitary crowns and fixed partial dentures, sometimes on dental implants, removable partial dentures are nowadays primarily indicated in patients with complaints about missing teeth in the aesthetic zone, which cannot be solved in another way. In addition to this, a removable partial denture is indicated in patients with extremely reduced dentitions or large or multiple edentulous areas, in patients with severe periodontitis or excessive loss of alveolar bone, in patients who are physically or emotionally vulnerable, as an interim solution on the way to edentulousness, as a temporary solution waiting for more extensive treatment and for patients who cannot afford an alternative.

Because loss of teeth many people have a reduced maxillary and mandibular dentition. The appropriate prosthetic rehabilitation is dependent on whether or not a standard mutilation of the dentition can be achieved. In this article, the focus is on treatment of a remaining mandibular dentition combined with an edentulous maxilla, whether or not with a reduced residual alveolar ridge. In the literature, there is no consensus on the appropriate prosthetic treatment if implant-supported overdentures are not applicable. The amount of bone loss in already during some time edentulous maxillary and mandibular alveolar ridge segments as well as the available vertical space for the removable (partial) denture are important decision-making factors.

Whether a shortened dental arch needs to be extended depends on the degree of the shortening. Four categories of shortened dental arches can be distinguished: 1. slightly shortened dental arches; 2. moderately shortened dental arches; 3. extremely shortened dental arches; and 4. asymmetrical extremely shortened dental arches. Decision-making on extending a shortened dental arch should be based on oral function and the patient’s perceived impact on oral health-related quality of life. According to this principle, there is no evidence for extending slightly shortened dental arches. Extending moderately shortened dental arches is indicated in exceptional cases, especially for aesthetic reasons. In the case of (asymmetrical) extremely shortened dental arches there are reasons for extension. The extension can be restricted to restoring the arch to the level of a moderately shortened dental arch. With this treatment strategy, it is possible in many cases to conform to the current trend of using fixed partial dentures rather than removable partial dentures.

After the placement of removable partial dentures, additional caries and periodontal problems may arise in the remaining dentition. These problems are the result of insufficient oral hygiene. Oral hygiene may be hampered by wearing the removable partial denture. The design of the removable partial denture should be carried out according to modern concepts of preventive dentistry. Before placing a removable partial denture, the patient’s mouth should be thoroughly healthy and the patient should be instructed properly on adequate oral care. Furthermore, the patient should be aware of his/her own responsibility for maintenance. If cleaning twice a day with fluoride toothpaste provides insufficient protection, care can be supported by daily use of a fluoride containing antimicrobial mouthrinse. Little effect can be expected from professionally applied fluoride or chlorhexidine solutions.